by Heel spurs can be excruciatingly painful, especially for athletes or those who spend much time on their feet. The recovery process can be slow and frustrating, but there are ways to speed it up. This article will reveal the secret to quicker heel spur recovery, including tips and techniques for reducing pain and promoting healing. Whether you’re an athlete, a busy professional, or simply someone looking to get back on your feet, this information can help you resume your daily routine faster and more comfortably.
What is Heel Spur?
Heel spurs are a common foot condition many people may have heard of but are not entirely sure what they are. Simply put, a heel spur is a bony growth that forms on the bottom of the heel bone. This growth results from calcium deposits that accumulate over time and can cause sharp pain and discomfort in the heel area. While heel spurs often occur with plantar fasciitis, they are two different pathologies. A heel spur can occur in people with no history of foot problems.
Symptoms of Heel Spur
The symptoms of heel spurs can vary from person to person but are often characterised by sharp pain and discomfort in the heel area. People with heel spurs may experience tenderness in the affected area, especially when standing or walking for prolonged periods. The pain may be worse in the morning, after a long period of sitting or resting, or after intense physical activity. Some people may also experience swelling, redness, or acute inflammation in the affected area, although these symptoms are less common.
In severe cases, heel spurs can also cause mobility issues, making walking or performing daily activities difficult. Only some people with heel spurs experience symptoms; some may only be aware of the condition once medically diagnosed. Heel spurs in and of themselves are often not problematic and usually don’t require treatment. Also, it often gets misdiagnosed as plantar fasciitis, Baxter’s nerve entrapment, fat pad contusion or calcaneal stress fracture.
Leading Causes of Heel Spur
There are several causes of heel spurs, some of which are preventable and others that result from age or underlying medical conditions.
Age
One of the primary causes of heel spurs is ageing. Our bones can weaken as we age, which in turn affects our gait. In the older population, longer contact time is spent on the heels and midfoot. There is also reduced step length. This places extra pressure on the heel bone, causing irritation, ossification and pressure on the surrounding tissue leading to inflammation and pain. Age-related heel spurs may occur in people with no history of foot problems and are not caused by any underlying medical conditions.
Plantar Fasciitis
It is hard to tell if plantar fasciitis directly causes heel spurs. However, studies have linked the presence of plantar fasciitis in 45-85% of people with heel spurs. Further, researchers believe that risk factors that lead to plantar fasciitis may also cause a heel spur to develop. For this reason, it is essential to have an accurate diagnosis to commence appropriate treatment.
Weight
Excess weight can put a significant strain on the feet and can lead to the development of heel spurs. The added pressure on the heel, especially in the presence of certain foot deformities, can cause inflammation of the plantar fascia and the heel spur leading to the formation of a symptomatic heel spur.
Gender
Gender can also play a role in the development of heel spurs. Women are more likely to develop heel spurs than men, primarily due to the types of shoes they wear. Altered foot biomechanics, high-heeled shoes and shoes with poor arch support can cause the feet to become misaligned, leading to the heel spurs becoming pathological.
Foot Position
How we stand and walk can also contribute to the formation of heel spurs. People who stand for long periods or walk on hard surfaces are more likely to develop heel spurs. Additionally, people with flat feet or high arches are at a higher risk of developing heel spurs. In fact, there is a strong correlation between pronation and the development of heel spurs. Studies have shown that 62% of people with a spur and 82% with a painful spur have pronated or flat feet.
Arthritides
Arthritides, or arthritis, are medical conditions that can cause joint inflammation and pain. Certain types of arthritis, such as rheumatoid arthritis and osteoarthritis, can also cause pathological heel spurs. The inflammation, pressure and erosion that occur due to age are believed to be the cause, leading to the development of painful heel spur.
Conservative Management for Quicker Heel Spur Recovery
While recovery from heel spurs can take several months or longer, conservative management can help speed healing. Conservative management refers to non-surgical treatment options that relieve pain, reduce inflammation, and promote healing. Here are some of the most effective conservative management techniques for quicker heel spur recovery.
Padding and Strapping of the Foot
Padding and strapping of the foot can help reduce pressure on the affected area and relieve pain. This technique uses unique padding materials (felt) and strapping tape (zinc oxide) to support the heel and reduce stress on the plantar fascia and heel spur. Padding and strapping can be done at home, or a healthcare provider can show or assist in applying the materials.
Insoles to Relieve Pressure on the Feet
Orthotics or insoles if you like, are another effective way to relieve pressure on the feet and reduce pain caused by heel spurs. Insoles can provide additional cushioning and support to the feet. They can be customised to fit the unique shape of the foot. A healthcare provider can create a custom or bespoke pair to suit the individual’s needs, or one can acquire them over the counter. Please note that over-the-counter insoles are less likely to be as effective as bespoke ones.
Calf and Plantar Fascia Stretching to Increase Flexibility
Stretching exercises can help increase flexibility and reduce tension in the calf and plantar fascia, which can help alleviate pain caused by heel spurs. When the calf and plantar fascia is tight, it alters gait making it less efficient, leading to delayed time on the heel and midfoot and hence more pressure on the heel spur. A healthcare provider can recommend specific stretching exercises to help stretch the calf and plantar fascia safely. A good stretching exercise I often recommend is the calf towel stretch, which can also stretch the plantar fascia.
Night Splint to Maintain Proper Alignment During Sleep
A night splint is a device worn during sleep to maintain proper foot alignment and reduce tension on the plantar fascia by keeping it stretched while sleeping. This device can help prevent the plantar fascia from becoming tight at night and can help alleviate pain caused by heel spurs in the morning if it’s associated with plantar fasciitis.
Physiotherapy to Strengthen Weak Muscles that Support the Feet
Weak intrinsic foot muscles can reduce the biomechanical integrity of the foot. Physiotherapy is an effective way to strengthen weak muscles that support the feet, which can help reduce pressure and pain caused by heel spurs. A healthcare provider can recommend specific exercises to help strengthen the muscles in the feet, ankles, and lower legs, which can help improve the overall stability and support of the feet. The toe towel crunch exercise is good; I often recommend it to my patients.
Cast or Immobilisation Boot
A cast or immobilisation boot can be used to reduce pressure on the heel and movement of inflamed tendons and ligaments, which can help promote healing of the affected area. This technique can be helpful for people who are experiencing severe pain or who have difficulty walking.
Extracorporeal Shockwave Therapy
Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that stimulates healing in the affected area. ESWT can aid in effectively reducing heel pain. Speak to your healthcare provider to determine if this option suits you.
It’s essential to remember that resting and elevating the leg are also critical to the healing process. Also, one should look into the type of footwear used, ensuring they can offload the affected area.
Medical Management for Quicker Heel Spur Recovery
When conservative management techniques fail to alleviate pain and promote the healing of heel spurs, medical management may be necessary. Medical management involves using medication or surgical intervention to reduce pain and inflammation and encourage quicker recovery. Here are some of the most effective medical management techniques for faster heel spur recovery.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Non-steroidal anti-inflammatory drugs (NSAIDs) are a common type of medication used to reduce pain and inflammation. NSAIDs block the enzyme called cyclooxygenase that the body uses to produce prostaglandins, which are involved in blood clotting and are responsible for pain and inflammation. Common NSAIDs include ibuprofen and naproxen. While NSAIDs can effectively reduce pain and inflammation, they can cause side effects such as stomach upset.
Steroid Injections For Severe Pain
Heel spur pain which is unresponsive to treratment can be reduced with steroid injections. Steroid injections work by reducing inflammation in the affected area. A healthcare provider can administer a steroid injection directly into the affected area to relieve pain quickly. While steroid injections can effectively reduce pain, they can cause side effects such as a flare, infection and damage to soft tissue.
Endoscopic Plantar Fasciotomy
Endoscopic plantar fasciotomy is a minimally invasive surgical procedure clinicians can use to treat heel spurs and other foot conditions. During this procedure, a small incision is made in the foot. A tiny camera is inserted to guide the surgeon as they remove the inflamed tissue and spur. The procedure is typically done under local anaesthesia. It can be done as an outpatient procedure, meaning the patient can go home the same day.
Endoscopic plantar fasciotomy is a popular treatment option because it has a shorter recovery time than traditional open surgery. Patients can usually begin walking immediately after the procedure and return to normal activities within a few weeks. The procedure has a high success rate, with most patients experiencing significant pain relief and improved foot function.
As with any surgical procedure, there are risks associated with endoscopic plantar fasciotomies, such as infection, nerve damage, and recurrence of the condition. However, these risks are relatively low, and most people who undergo the procedure do not experience any complications.
Overall, endoscopic plantar fasciotomy is an effective and safe surgical option for people experiencing severe pain and limited mobility due to heel spurs. If conservative management techniques have not been effective in treating the condition, your healthcare provider may recommend endoscopic plantar fasciotomy as an option for relief.
In-step fasciotomy
Like endoscopic plantar fasciotomy, in-step fasciotomy is a surgical procedure to treat chronic heel pain caused by heel spurs. During the procedure, an incision is made on the bottom of the foot, and the plantar fascia is partially released from the heel bone to reduce the tension in the affected area. This procedure can be performed under local anaesthesia and is also done on an outpatient basis.
In-step fasciotomy is a relatively simple surgical procedure that can effectively relieve chronic heel pain. However, like all surgical procedures, it comes with some risks, such as infection and tissue damage. In-step fasciotomy is typically reserved for people who have not found relief from conservative management techniques or have severe symptoms affecting their daily activities. Your healthcare provider can help you determine whether this procedure is the right option for you and can provide more information on what to expect during and after the procedure.
Conventional Radiofrequency Ablation
The Radiofrequency ablation (RFA) technique uses radio waves to heat. It destroys the fibres around the heel spur. It is applied above, at the tip and below. RFA can provide short- and intermediate-term relief from pain and discomfort caused by heel spurs without surgery.
During the RFA procedure, a small needle is inserted into the affected area under local anaesthesia. The needle is guided using imaging technology to the affected area. Once in position, the needle is heated using radio waves, which destroys the fibres and prevents them from transmitting pain signals.
RFA is a safe and effective procedure with minimal risk of complications. The surgery is usually performed on an outpatient basis, and relief can last for 2-6 months. People who undergo RFA for heel spurs can resume their daily activities shortly after the procedure, with little to no downtime. If you’re experiencing symptoms of heel spurs and have not found relief from other conservative management techniques, RFA may be an option worth considering.
Final thoughts
Heel spurs can be a painful and uncomfortable condition that significantly affects a person’s daily life. Fortunately, various conservative management techniques are available to help speed up recovery and provide relief. From padding and strapping of the foot, insoles, calf and plantar fascia stretching, night splints, physiotherapy, cast or immobilisation boot, and ESWT, these techniques have a high success rate in reducing inflammation and pain associated with heel spurs.
In severe cases, surgical intervention in the form of endoscopic plantar fasciotomy may be necessary. It is vital to seek medical advice promptly to receive proper treatment and prevent the condition from worsening. With the appropriate care and support, people with heel spurs can achieve a full and speedy recovery and return to their daily activities with minimal discomfort.
Here are Some Questions to Ask Your Doctor for a Better Understanding of Heel Spur
- Are there any lifestyle changes I can make to help alleviate the pain and discomfort caused by heel spurs?
- Are there any medications or supplements that can help reduce inflammation and pain associated with heel spurs?
- What can I do to prevent the recurrence of heel spurs in the future?
- Is it safe to continue exercising or playing sports while recovering from heel spurs, or should I take a break?
- How long can I expect my recovery to take, and when can I return to my normal activities?
- Are there any warning signs I should look out for that indicate my heel spur is getting worse?
- Should I be referred to a specialist, such as a podiatrist, for further evaluation or treatment of my heel spur?
References
1. Barrett, S.L. and Day, S.V. (1991). Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique–early clinical results. The Journal of Foot Surgery, [online] 30(6), pp.568–570. Available at: https://pubmed.ncbi.nlm.nih.gov/1770208/ [Accessed 21 Feb. 2023].
2. Kirkpatrick, J., Yassaie, O. and Mirjalili, S.A. (2017). The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. Journal of Anatomy, 230(6), pp.743–751. doi:https://doi.org/10.1111/joa.12607.
3. Velagala, V.R., Velagala, N.R., Kumar, T., Singh, A. and Mehendale, A.M. (2022). Calcaneal Spurs: A Potentially Debilitating Disorder. Cureus. doi:https://doi.org/10.7759/cureus.28497.
4. Yürük, D. (2021). The Effectiveness of Conventional Radiofrequency Ablation for Chronic Plantar Heel Pain Due to Heel Spur. The Journal of The Turkish Society of Algology. doi:https://doi.org/10.14744/agri.2021.82542.
